Journal of the American Medical Informatics Association : JAMIA
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To determine the accuracy of vendor-supplied dosing eRules for pediatric medication orders. Inaccurate or absent dosing rules can lead to high numbers of false alerts or undetected prescribing errors and may potentially compromise safety in this already vulnerable population. ⋯ The accuracy of a vendor-supplied set of dosing eRules is suboptimal when compared with traditional dosing sources, exposing a gap between dosing rules in commercial products and actual prescribing practices by pediatric care providers. More research on vendor-supplied eRules is warranted in order to understand the effects of these products on safe prescribing in children.
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J Am Med Inform Assoc · Feb 2014
Appropriateness of commercially available and partially customized medication dosing alerts among pediatric patients.
To evaluate dosing alert appropriateness, categorize orders with alerts, and compare the appropriateness of alerts due to customized and non-customized dose ranges at a pediatric hospital. ⋯ The vast majority of dosing alerts were presented to practitioners inappropriately, potentially contributing to alert fatigue. Appropriate alerts occurred more often when alerts were due to customized ranges. Advances in dosing alerts should aim to provide accurate and clinically relevant alerts that minimize excessive inappropriate alerting. Medications requiring dosing adjustments based on clinical parameters must be taken into account when designing and evaluating dosing alerts.
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J Am Med Inform Assoc · Feb 2014
Exploring the sociotechnical intersection of patient safety and electronic health record implementation.
The intersection of electronic health records (EHR) and patient safety is complex. To examine the applicability of two previously developed conceptual models comprehensively to understand safety implications of EHR implementation in the English National Health Service (NHS). ⋯ Using sociotechnical models, including those presented in this paper, may be beneficial to help stakeholders understand, synthesize, and anticipate risks at the intersection of patient safety and health information technology.
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J Am Med Inform Assoc · Feb 2014
Electronic medical records and physician stress in primary care: results from the MEMO Study.
Little has been written about physician stress that may be associated with electronic medical records (EMR). ⋯ Stress may rise for physicians with a moderate number of EMR functions. Time pressure was associated with poor physician outcomes mainly in the high EMR cluster. Work redesign may address these stressors.